Periorbital hyperpigmentation in Asians: an epidemiologic study and a proposed classification

Area of Science:

• Dermatology
• Ophthalmology
• Medical Aesthetics

Background:

• Periorbital hyperpigmentation (POH) is characterized by darkened skin around the eyelids.
• The causes of POH are multifactorial and not well-defined.

Purpose of the Study:

• To determine the prevalence of POH in Singapore.
• To propose a classification system for POH based on its causes.

Main Methods:

• An epidemiologic study involving 1000 consecutive patients at a dermatology clinic.
• Detailed history, clinical examination, and expert dermatological assessment for 200 patients with POH.
• Objective measurement of POH extent using a mexameter.

Main Results:

• Vascular type (41.8%) was the most frequent cause of POH.
• Constitutional (38.6%), postinflammatory (12%), and shadow effects (11.4%) were other identified causes.
• Ethnic variations observed: vascular type predominant in Chinese, constitutional type in Indians and Malays.

Conclusions:

• The vascular form of POH is the most prevalent type.
• A comprehensive classification for POH is proposed.
• The proposed classification aims to guide future treatment decisions for POH.